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Author Spotlight: Advancing Awake Nasotracheal Intubation with Flexible Video Rhino-Laryngoscopes
Published on: August 2, 2024
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Learning fiberoptic intubation for awake nasotracheal intubation
Hyuk Kim1, Eunsun So2, Myong-Hwan Karm2
1Department of Dental Anesthesiology, School of Dentistry, Seoul National University, Seoul, Korea.
Journal of Dental Anesthesia and Pain Medicine
|January 20, 2018
Summary
Fiberoptic nasotracheal intubation (FNI) success rates improve with resident experience. Increased FNI practice, even with nasal bleeding, leads to fewer complications and better outcomes for patients requiring airway management.
Area of Science:
- Anesthesiology
- Medical Education
- Airway Management
Background:
- Fiberoptic nasotracheal intubation (FNI) is a critical technique for managing difficult airways.
- Training is essential for inexperienced operators to prevent complications.
Purpose of the Study:
- To evaluate the learning curve and success rates of residents performing FNI.
- To identify factors influencing FNI success and failure.
Main Methods:
- Residents performed FNI on 716 patients, with a 2 min 30 s time limit for the first attempt.
- Success was evaluated by intubation time, and nasal bleeding was assessed.
- Intubations were categorized by patient anesthesia status (awake vs. anesthetized).
Main Results:
- Overall FNI success rates were 88.3% on the first attempt and 94.6% on the second.
- Failure rates were 4.9% in anesthetized and 13.6% in awake patients.
- Success significantly improved with >30 FNI procedures performed by residents, regardless of nasal bleeding.
Conclusions:
- Resident experience is a key determinant of FNI success.
- Increased practice leads to improved FNI outcomes, even in the presence of nasal bleeding.
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